95% of Districts in UP & Bihar report less than 10% Vaccination Coverage
Sai Krishna Muthyanolla
June 5, 2021
In the previous story, we had observed the stark differences in vaccine coverage among various states with UP, Bihar, Tamil Nadu etc. lagging behind others. District wise data indicates that 95% of the districts in UP & Bihar have reported less than 10% vaccine coverage i.e., population receiving at least one dose.
In the previous story, we reviewed the status of Vaccination across various States/UTs in the country. Significant differences were observed in the vaccine coverage among the states, with U.P, Bihar, Tamil Nadu, Jharkhand & Assam having vaccinated less than 10% of their respective populations with at least one dose.
In this story, we take a look at more granular data i.e., vaccination across the districts to get a more detailed understanding of the trends in vaccination coverage.
Methodology: As in the earlier story, population of the districts from 2011 Census is taken as the base since no other latest population data is available.
Less than 10% of the population received at least one dose in 40% of the districts
Among the 639 districts that have been analysed based on 2011 Census, 40 districts have vaccination coverage of less than 5%. A further 216 districts have Vaccination coverage ranging from 5% to 10%. Overall, around 40% of all the districts in the country have reported a vaccination coverage of less than 10%.
A higher proportion i.e.  43% of the districts have reported a vaccination coverage between 10% and 20%. The vaccination coverage ranges from 20-30% in about 14% of the districts. Only about 3% of districts have managed to vaccinate more than 30% of their population with at least one dose. Only 16 districts have vaccinated more than 10% of their population with both doses.
Since the population of the districts is based on projections and not actual data, there could be some variances on ground. However, these numbers are broadly indicative of the trends.
95% of the districts in Bihar & Uttar Pradesh have Vaccination coverage of less than 10%
In the earlier analysis of the states, it was observed that U.P, Bihar, Tamil Nadu, Jharkhand & Assam have reported a vaccination coverage of less than 10% of their population. The district-wise numbers also reflect this trend.
Among the 38 districts in Bihar, 37 districts have reported a vaccination coverage of less than 10%. In Uttar Pradesh, 67 out of the 71 districts have reported vaccination coverage of less than 10%. In other words, 97% and 94% of the districts in Bihar & U.P respectively have reported vaccination coverage of less than 10%, bringing down the overall numbers for the state.
Comparatively, Tamil Nadu, Jharkhand & Assam fare better in terms of distribution of the districts with lower vaccine coverage.  Tamil Nadu has around 81% districts with less than 10% vaccination coverage, while it is 79% and 78% in Jharkhand & Assam respectively. Madhya Pradesh is another state which has more than 70% of the districts with less than 10% vaccination coverage. Among the other large states, vaccination coverage is less than 10% in half of the 20 districts in Punjab and 9 of the 19 districts in West Bengal.
Vaccination Coverage is less than 10% in about 15% of the Urban and 44% of the Rural districts
The only district in Bihar which has reported more than 10% vaccination coverage is Patna, the capital city. As per the 2011 Census, Patna district has around 43% Urban population.  Even in Uttar Pradesh, the districts that reported more than 10% vaccination coverage are predominantly urban.  All the four districts with more than 10% vaccination Coverage in Uttar Pradesh are Urban-majority districts. In fact, the district of Gautam Buddha Nagar, which is part of NCR (National Capital Region) has reported around 26% of vaccine coverage. The one urban-majority district which is not part of this list is Kanpur Nagar which reported only 9% vaccine coverage.
The same is observed even in the case of other states with lower vaccine coverage – Assam, Jharkhand & Tamil Nadu etc. In all these states, districts with comparatively higher vaccine coverage are either districts with Urban-majority population or districts which have a city or a major town.
As indicated earlier, the criteria of categorization of Urban & Rural is based on the district’s projected population from the 2011 Census.  There could be certain districts which have a majority rural-majority population but have major urban dwelling, like in the case of Patna.
The Urban-Rural divide in terms of vaccination coverage is also visible at the national level.
Out of the 639 districts as per 2011 Census that are analysed, 557 are Rural-majority districts and 82 are Urban-majority districts. Around 44% of the Rural-majority districts have reported vaccination-coverage of less than 10%, while it is only 15% among the Urban-majority districts.
Around 36% districts reported less than 50% vaccination coverage among 60+ age group
As noted in the previous story, 62% of the population in the 60+ age group have received at least a single dose of vaccination. However, the distribution is not uniform among the districts.
Around 36% of the districts have reported a vaccination coverage of less than 50% among its 60 + age group population. As highlighted earlier, vaccination coverage here indicates population receiving at least one dose of the vaccine.
Most of the district with lower coverage are in Uttar Pradesh & Tamil Nadu. Bihar, Assam & Jharkhand have a slightly better coverage in the 60+ age group. Meanwhile, around 24% of the districts have reported more than 90% vaccination coverage among the 60+ age group. A total of 66 out of 82 Urban majority districts have reported a vaccination coverage of more than 90% among the 60+ age group.
In the 45-60 age group, only 27% of the districts reported a vaccination coverage of more than 50%
About 38% of the population in the age-group of 45-60 years has received at-least one dose of vaccination. This is comparatively lower than coverage in the 60+ age group.
The difference is even more stark if the districts with a higher vaccination coverage are concerned.  As pointed out earlier, 24% of the districts reported a vaccination coverage of more than 90% among the 60+ age group. But this is only around 6% or 38 districts, for 45-60 age group.
Only about 27% of the districts have reported vaccination coverage of more than 50% among the 45-60 age group. The concentration of urban-majority districts among those with a higher vaccination coverage is not as evident as seen in the case of 60+ age group. This may be due to the overall lower vaccination coverage of this age group.
Apart from state-wise variation, a clear rural-urban divide is visible in vaccination coverage
The trends in vaccination coverage across the districts largely conform to the trends observed in the analysis of the states. Most of the districts with low vaccine coverage belong to the states of U.P, Bihar, Tamil Nadu, Assam & Jharkhand, which also happen to be the states with lower vaccine coverage.
As observed in this story, a majority of the districts in these states have vaccinated (single dose) less than 10% of their population with at least one dose. The proportion of population that received both doses is much lower.
The district-wise trends also match the overall state-wise & age-group wise trends. The state wise variances are also reflected in the age-related trends, with most of the districts with lower vaccination coverage in respective age-groups belonging to states with overall lower vaccine coverage.
Another important trend which the district-wise data reveals is the stark difference between Urban & Rural vaccine coverage. Urban-Majority districts have fared well in vaccinating a higher proportion of their population compared to the districts with majority Rural population.  This brings to the fore the questions around vaccine hesitancy, awareness, health infrastructure, supply & distribution challenges etc.
A different strategy is the need of the hour to increase the vaccine coverage in districts that are lagging behind, with a special focus on rural areas.  Further delay could create potential future waves of COVID-19 infection in states with poor health infrastructure.
Featured Image: Vaccination Coverage in Indian states